FINMA is responsible for supervising health insurers offering supplementary health insurance. It ensures that insurers are financially stable, provide transparent information about their products and that premiums are justified. In this way, it protects both the entire body of policyholders and the interests of each individual.
FINMA supervises private insurance companies that offer supplementary health insurance. Its goal is to ensure that insurers are financially stable. And to protect policyholders from improper conduct. The market for supplementary health insurance is not considered to be very transparent because benefits, premiums and contractual terms and conditions are difficult to compare.
FINMA and supplementary health insurance
FINMA's role in supervising companies offering supplementary health insurance
FINMA reviews products and premiums before they are launched on the market
FINMA reviews new insurance products and subsequent changes to them. An insurer may only offer a new product once FINMA has approved the tariff and the general terms and conditions of insurance. The premiums must not be excessive and the insurer must be in a position to pay the agreed benefits at all times.
Protection against unequal treatment and opaque billing
FINMA intervenes when policyholders are treated unequally for no objective reason, particularly when it comes to premiums, discounts and settlement. Such as when policyholders pay different premiums for comparable risks for no good reason. Or if a policyholder receives a discount on premium payments without the conditions for this being met. Because this can lead to other policyholders having to pay more.
FINMA also takes its supervisory duties seriously when it comes to the settlement of benefits. Opaque or incomprehensibly high bills were found to have been issued by individual service providers (e.g. clinics or doctors). FINMA’s supervisory requirements and controls have enabled insurers to reduce prices and premiums for in-patient hospital stays since 2020 – a direct benefit for policyholders.
Information must be provided
Insurers have a duty to inform their customers. They must provide clear information about the contract, benefits, premiums and notice periods. FINMA monitors compliance with these information obligations. If a supplementary insurance product is no longer offered, it must be possible to switch to a comparable product, if available.
Protection against aggressive advertising by insurance intermediaries
Thanks to new rules under the industry agreement 3.0, insurance intermediaries are no longer allowed to make unsolicited advertising calls. Referral bonuses (commissions) are capped in order to reduce false incentives. FINMA monitors compliance and takes action if intermediaries or insurers violate the requirements or mislead policyholders. If you suspect a violation, report the matter to FINMA. It checks such reports carefully and intervenes where necessary.
Did you already know?
FINMA supervises private insurance companies, including supplementary health insurers. Compulsory health insurance under the Health Insurance Act, on the other hand, is overseen by the Federal Office of Public Health (FOPH). |
In the second part of this series, we will show you how you can make sure you get the best insurance cover.
